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Diabetic Coma in Type 2 Diabetes

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Hyperglycemic hyperosmolar nonketotic syndrome -- is a type of diabetic coma that can happen to a person with diabetes who is ill or whose body is stressed. It occurs more in people with type 2 diabetes as opposed to type 1 diabetes. 

Diabetic coma occurs when the blood sugar gets too high and the body becomes severely dehydrated. Unlike ketoacidosis, which typically occurs in people with type 1 diabetes and produces similar symptoms, no ketones are formed in diabetic coma. So rarely is there an acid build up in the blood. Ketoacidosis rarely occurs in people with type 2 diabetes.

Hyperglycemic hyperosmolar nonketotic syndrome occurs most often among older people. This may be because older people often have an altered sense of being thirsty and are more likely to become dehydrated. Most sufferers have a history of diabetes, but for some, the disease is undiagnosed or untreated.

In most cases, there is a history of excess thirst and urination for weeks prior to diagnosis. Excess urination and extreme elevations of blood sugar levels lead to dehydration throughout the body, including cells becoming dehydrated. The severe loss of body water can lead to shock, coma, and death. Death rates can be as high as 40%.

People who are especially at risk include those who are chronically ill or disabled.

What Causes Diabetic Coma?

Causes of diabetic coma can include:

  • Infection
  • Heart attack
  • Kidney failure
  • Medicines (diuretics, some heart medications, or steroids)
  • Illness
  • Bleeding ulcer
  • Blood clot
  • Uncontrolled blood sugar

What Are the Warning Signs of Diabetic Coma?

Symptoms of diabetic coma can include:

  • Increased thirst
  • Increased urination
  • High fever
  • Weakness
  • Drowsiness
  • Altered mental state
  • Headache
  • Restlessness
  • Inability to speak
  • Visual problems
  • Hallucinations
  • Paralysis

Diabetic coma typically occurs when blood sugar reaches 600 mg/dL (milligrams per deciliter) or more.

If you have any of these symptoms, seek immediate medical help. They can lead to coma, seizures, or death.

How Is Diabetic Coma Treated?

Once early symptoms of a diabetic coma are noticed, treatment typically requires hospitalization with intravenous fluids and electrolytes such as potassium as well as insulin as ordered by your doctor. The coma can lead to death if left untreated.

How Can Diabetic Coma Be Prevented?

Diabetic coma can be prevented by the following:

  • Check your blood sugar regularly, as recommended by your health care provider.
  • Know your target blood sugar ranges and what to do if the readings are out of range.
  • Have a sick day plan that will spell out how often to check your blood sugar when you are sick.
  • Take special care of yourself when you are sick.


WebMD Medical Reference

Reviewed by Melinda Ratini, DO, MS on July 12, 2014
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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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